Serum Lipoprotein(a) as A Marker of Severity of Coronary Artery Disease in Aortic Valve Sclerosis Patients

Q: What are the key findings of this study?

Elevated serum Lipoprotein(a) greater than 30 mg/dL in patients with aortic valve sclerosis was significantly associated with more severe coronary lesions, as reflected by a higher mean SYNTAX score (35.07 vs 14.76) and a greater prevalence of 3-vessel disease (51.73% vs 4.77%).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Aortic Valve Sclerosis (AVS) with suspected Coronary Artery Disease (CAD) (n=100). Intervention: Elevated serum Lipoprotein(a) (>30 mg/dL) vs. Normal serum Lipoprotein(a) (≤30 mg/dL). Primary outcome: Mean SYNTAX score (p=<0.001).

Q: What does this research mean for the field?

Elevated serum lipoprotein(a) levels exceeding 30 mg/dL are significantly associated with greater coronary artery disease severity and higher SYNTAX scores in patients with aortic valve sclerosis. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the correlation between serum lipoprotein(a) levels and the anatomical severity and complexity of coronary artery disease in patients with aortic valve sclerosis.

Remon Saleh Adly; Sally Magdy Teima; Shereen Philip Aziz; Ahmed Ibrahim Bedier

doi:10.4274/ijca.2026.86548

July 13, 2026International Journal of the Cardiovascular AcademyOpen Access

Serum Lipoprotein(a) as A Marker of Severity of Coronary Artery Disease in Aortic Valve Sclerosis Patients

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Key result

Elevated Lp(a) is linked to ~20-point higher SYNTAX scores in aortic valve sclerosis.

P<0.001
n=100

Why the study?

Aortic valve sclerosis and coronary artery disease share risk factors, but the correlation between serum Lipoprotein(a) levels and CAD severity in AVS patients was unclear.

Does elevated serum Lipoprotein(a) predict greater coronary artery disease severity in patients with aortic valve sclerosis?

Key Points

To evaluate the correlation between serum lipoprotein(a) levels and the anatomical severity and complexity of coronary artery disease in patients with aortic valve sclerosis.
Cross-sectional single-center study of 100 individuals with established aortic valve sclerosis presenting with chest pain and/or dyspnea provisionally diagnosed with coronary artery disease.
Participants were stratified by serum Lp(a) into a normal-level group (n=42; mean 16.68 mg/dL with a 30 mg/dL cutoff) and a high-level group (n=58; mean 55.68 mg/dL).
Coronary angiography was used to evaluate lesion significance, the number of diseased epicardial coronary arteries, and lesion complexity using the SYNTAX score.
Three-vessel disease was present in 51.73% of patients in the high Lp(a) group versus 4.77% in the normal group, while single-vessel disease occurred in 3.45% versus 66.66%, respectively (P < 0.001).
The SYNTAX score was significantly higher in the elevated Lp(a) group (35.07±6.08) compared to the normal Lp(a) group (14.76±4.5) (P < 0.001).
Angiographically significant coronary lesions occurred in 75.88% of the high Lp(a) group versus 28.58% of the normal group (P < 0.001), and Lp(a) remained an independent predictor of high SYNTAX score on multivariate regression analysis (P = 0.001).

Study Design

Type

Cross-Sectional (n=100)

Multicenter

No

Structured PICO

Does elevated serum Lipoprotein(a) predict greater coronary artery disease severity in patients with aortic valve sclerosis?

P

Population

100 adults (mean age 60.8 years, 32% female) with established aortic valve sclerosis and symptoms of suspected coronary artery disease, evaluated cross-sectionally.

E

Exposure

High serum Lipoprotein(a) level (>30 mg/dL)

C

Comparator

Normal serum Lipoprotein(a) level (≤30 mg/dL)

O

Outcome

Severity of epicardial coronary lesions (number of diseased coronary arteries) and complexity of coronary lesions measured by SYNTAX scoresurrogate

Main Result

Absolute Event Rate: 35.07% vs 14.76%

p-value: p=<0.001

Elevated serum Lipoprotein(a) is independently associated with greater coronary artery disease severity and complexity in patients with aortic valve sclerosis.

Limitations

Relatively small sample size and conducted at a single center
Baseline characteristics were not homogeneous between study groups (potential residual confounding)
Selection bias due to inclusion of symptomatic AVS patients referred for coronary angiography
Lp(a) measurement was performed approximately one month after discharge, introducing potential variability
Absence of longitudinal clinical outcomes precludes assessment of prognostic implications
Small sample size
Single-center study
Baseline characteristics were not homogeneous between study groups
Measurement of Lp(a) approximately one month after discharge
Absence of longitudinal clinical outcomes

Implication

May flag extensive CAD in aortic valve sclerosis; leaves open whether Lp(a) measurement or lowering changes management.

Abstract

Background and Aim: Aortic valve sclerosis (AVS) and severity of coronary artery disease (CAD) share common risk factors, but not all patients have the same severity of coronary lesions.Lipoprotein(a) [Lp(a)] is a significant, causal, and non-modifiable indicator of valvular outcomes and CAD in the general population.This study aimed to evaluate the correlation between serum Lp(a) level and CAD severity in individuals with AVS. Materials and Methods:This cross-sectional study was conducted in 100 individuals with an established diagnosis of AVS who had chest pain and/or dyspnea and were provisionally diagnosed with CAD.Participants were subdivided into two groups: the normal-level group (n=42), with a cut-off serum Lp(a) level of 30 mg/dL.High level group (n=58): high-risky Lp(a) level.Results: A significant correlation was observed between the number of diseased epicardial coronary arteries and high Lp(a) levels [51.73% vs. 4.77% for 3-vessel disease, and 3.45% vs. 66.66% for one-vessel disease, in the high and normal Lp(a) groups, respectively] (P < 0.001).SYNTAX score had been elevated (35.07±6.08) in those with elevated Lp(a) level contrasted to reduced Lp(a) (14.76±4.5 SD) (P < 0.001).Conclusions: Elevated serum Lp(a) was significantly associated with greater coronary lesion severity and higher SYNTAX scores among patients with AVS.

Discussion

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Cite This Study

Adly et al. (2026) conducted a cross-sectional in Aortic Valve Sclerosis (AVS) with suspected Coronary Artery Disease (CAD) (n=100). Elevated serum Lipoprotein(a) (>30 mg/dL) vs. Normal serum Lipoprotein(a) (≤30 mg/dL) was evaluated on Mean SYNTAX score (p=<0.001). Elevated serum Lipoprotein(a) greater than 30 mg/dL in patients with aortic valve sclerosis was significantly associated with more severe coronary lesions, as reflected by a higher mean SYNTAX score (35.07 vs 14.76) and a greater prevalence of 3-vessel disease (51.73% vs 4.77%).

synapsesocial.com/papers/6ad0fc263afa093ea9acfc7f https://doi.org/10.4274/ijca.2026.86548

Topics

Coronary artery disease

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Serum Lipoprotein(a) as A Marker of Severity of Coronary Artery Disease in Aortic Valve Sclerosis Patients

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

Serum Lipoprotein(a) as A Marker of Severity of Coronary Artery Disease in Aortic Valve Sclerosis Patients

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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Topics

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